How HIV Spreads

Many people still do not understand how HIV is passed, or transmitted, from
one person to another. Knowing the basics helps you avoid getting the virus if
you are HIV-negative, and avoid giving it to someone else if you are living
with HIV (HIV+).

HIV is spread through contact with the following body fluids:

Blood (including menstrual blood)

Semen ("cum") and other male sexual fluids ("pre-cum")

Vaginal fluids

Breast milk

HIV is also spread through contact with these body fluids; however, usually
only health care workers come into contact with these fluids:

Fluid around the brain and spinal cord (cerebrospinal fluid)

Fluid around the joints (synovial fluid)

Fluid around a developing fetus (amniotic fluid)

HIV is not spread through contact with these body fluids:

Sweat

Tears

Saliva (spit)

Feces (poop)

Urine (pee)

The spread of HIV can be prevented! There are ways to avoid, or at least
reduce, contact with body fluids that spread HIV. This info sheet explains
how.

Methods of Transmission

Today, the most common ways HIV is passed from one person to another
are:

Injecting Drugs (including steroids or hormones): Many HIV infections occur when people share the
equipment used to inject heroin, methamphetamines, steroids, hormones, or other
drugs. Re-using syringes, needles, water, spoons, "cookers," or "cottons" can
spread HIV. Be sure to use syringes and needles only from reliable sources,
such as needle exchange programs or pharmacies. Many cities offer free needle
and syringe exchange programs. For more information, see our info sheet on Cleaning Works.

Tattoos or Body Piercings: Tattoos or body piercings should always
be done by a licensed professional whose equipment is sterile. The Centers for
Disease Control and Prevention (CDC) recommends that instruments be used only once and then
thrown away. Reusable instruments must be sterilized between uses. Using
alcohol to clean instruments is not sufficient. Proper sterilization involves
having instruments steam sterilized, or autoclaved

Unprotected/Unsafe Sex

Advertisement

Every sexual act (oral, anal, or vaginal) that involves sexual fluids has at least some risk. Barriers, such as condoms (male and female),
dental dams (thin squares of latex), and latex gloves help reduce risk
substantially.

Unsafe sex (sex without condoms or barriers) puts you and/or your partner at
risk for HIV or other sexually transmitted diseases (STDs).

Safer sex (sex using condoms or other barriers consistently and correctly) is the
most effective way to protect you and your partner.

Which common sexual activities are most likely to cause HIV transmission
when safer sex isn't used? Listed from most to least risky:

Receptive anal sex ("bottoming"): Taking a penis through
one's anus and into one's rectum remains the most risky activity. This is due
to the likelihood of small tears in the rectum that allow semen ("cum") to have
direct contact with the bloodstream.

Receptive vaginal intercourse: This refers to taking a penis into
one's vagina. HIV is transmitted from men to women much more easily than from
women to men.

Receiving oral sex: Having your genitals licked, sucked, or bitten
is less risky than giving oral sex. However, you can get HIV from your partner,
especially if your partner has bad oral hygiene.

Sharing sex toys without sterilizing them or using a new condom:
This can allow HIV to be transmitted from the first partner to the next one who
uses the toy.

Mutual masturbation (hand jobs) and fisting (using a hand to penetrate
the anus or vagina): These are relatively low risk, as long as your hand
has no open cuts or sores.

Sexual assault or rape can result in infection if the attacker is HIV+. The
risk increases when rape involves anal penetration, force, and/or multiple
attackers. Some forced sexual acts involving wounds can place a victim at very
high risk.

Survivors of sexual assault or rape who do not already have HIV should be
routinely offered PEP (post-exposure prophylaxis; also called non-occupational
PEP, or nPEP) in emergency rooms. This 28-day treatment with HIV drugs greatly
reduces the chances of becoming infected with HIV. PEP must be started within
the first 72 hours of exposure to be effective. The earlier treatment is
started, the more effective it will be. If PEP is not offered in the emergency
room or clinic after a rape or sexual assault, do not be afraid to ask for it.
The CDC issued recommendations for PEP following non-occupational exposures
like sexual assault and rape in 2005.

Mother-to-Child Transmission

HIV+ mothers can pass the virus to their babies while pregnant, during
birth, or by breastfeeding. Medical care and HIV drugs given during pregnancy
can almost eliminate the risk of a baby getting HIV from its mother. In
high-income countries like the US, it is recommended that HIV+ mothers not
breastfeed their babies. For more information, see our Pregnancy and HIV info sheet.

Other Types of Transmission

In the past, HIV was spread by transfusion with blood products, such as
whole blood or the "factor" used by hemophiliacs. Many people were
infected this way. The blood supply is now much more strictly tested and
controlled. The odds of being infected from receiving blood or blood factor in
the US are very low.

It is also possible to get HIV from skin grafts or transplant organs taken
from HIV+ people. Again, the risk is considered very low, as these 'body
products' are required to be strictly tested in the same way as blood products.
Semen donations collected by sperm banks for artificial insemination are also
considered 'body products' and strictly tested. Private semen samples that are
not processed by sperm banks or similar organizations are not subject to the
same testing. It is important for anyone receiving a private donor's sperm for
artificial insemination to have the donor tested for HIV.

You cannot get HIV from donating blood -- a new, sterile (clean) needle is
used for each donation.

Advertisement

Some people, mostly health care workers, are infected through needle sticks
with infected blood, or through other medical accidents. This is a very small
percentage of overall infections. When exposed to fluid or body products that
may be infected while on the job, health care workers are offered occupational
post-exposure prophylaxis (oPEP).

Rare Types of Transmission

There are a few isolated cases of people becoming infected from using a
razor that had just been used by an HIV+ person, or from using a toothbrush
immediately after the toothbrush was used by someone who was HIV+, or in other
unexpected ways. One case of transmission occurred when two people, both of
whom had terrible dental problems, engaged in deep or "French" kissing.
However, the odds of getting HIV from kissing, even when one person is HIV+,
are less than the odds of being struck by lightning. To be safe, always avoid
direct contact with blood and sexual fluids.

Avoiding Transmission

HIV cannot be transmitted except when certain body fluids are exchanged. You
can greatly reduce the risk of transmission by:

Knowing your HIV status so you can take steps to avoid spreading HIV if you
are HIV+

Practicing safer sex

Having unprotected sex only if you and your partner are both HIV-negative and in a
monogamous relationship

Abstaining from sex

Not injecting drugs

Using new or clean needles for any injections

Staying on your HIV drug regimen if you are HIV+. This will keep your viral
load as low as possible. Keeping your viral load low will reduce the risk of
your passing HIV to others (sexual partners, mother-to-child).

You do not need to be afraid of getting or passing HIV by casual contact.
Remember, HIV is not transmitted by:

Hugs

Dancing

Sharing food or drinks

Using a shower, bath, or bed used by an HIV+ person

Kissing (between people with no significant dental problems)

Sharing exercise equipment

Bug bites

This article was provided by The Well Project.
You can find this article online by typing this address into your Web browser:
http://www.thebody.com/content/art58889.html

General Disclaimer: TheBody.com is designed for educational purposes only and is not engaged in rendering medical advice or professional services. The information provided through TheBody.com should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, consult your health care provider.